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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Primary palmar hyperhidrosis is a socially and occupationally debilitating disorder characterized by excessive sweating&#46; The purpose of this study was to evaluate the results&#44; complications&#44; and degree of satisfaction among patients who underwent video-assisted bilateral thoracoscopic sympathectomy of the second and third ganglia &#40;T2-T3&#41; to treat primary palmar hyperhidrosis at the Department of General and Thoracic Surgery of the Hospital Universitario Virgen Macarena in Seville&#44; Spain&#46;</p> <span class="elsevierStyleSectionTitle">Material and method</span><p class="elsevierStyleSimplePara elsevierViewall">A study of 226 thoracoscopic sympathectomies was undertaken based on case histories and a prospective pre- and postoperative questionnaire survey&#46; The sample was composed of 113 patients &#40;47 males and 66 females&#41;&#44; ranging in age from 14 to 50 years&#44; with primary palmar and axillary hyperhidrosis&#44; in some cases severe&#46; Bilateral video-assisted thoracoscopic T2-T3 sympathectomy was performed under general anesthesia in all cases&#46; Follow up included a questionnaire on pre- and postoperative quality of life and degree of satisfaction&#46; Descriptive statistics on the surgical procedure&#44; quality of life&#44; and postoperative changes were compiled and frequency analyzed&#46; A nonparametric Wilcoxon test for paired variables was performed to contrast significant differences between pre- and postoperative quality of life related to hyperhidrosis and its complications&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The therapeutic success rate was 100&#37;&#46; Complications were seen in 14&#46;2&#37; of the cases and included hemothorax in two&#44; hemopneumothorax in three&#44; pleural hemorrhage in two&#44; and minimal apical airspace in nine&#46; Of the 106 patients who were monitored over a period of 6 to 12 months through follow-up interviews and questionnaires&#44; 67&#37; developed compensatory sweating&#44; 95&#37; reported improvement in quality of life&#44; and 4&#37; experienced no change in quality of life&#44; mainly because of the emergence of compensatory sweating&#46; Of the patients interviewed&#44; 97&#46;2&#37; said that they would undergo the operation again&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">Video-assisted thoracoscopic sympathectomy for the treatment of primary palmar hyperhidrosis is effective&#44; with low rates of morbidity and no mortality&#46; Despite the appearance of postoperative changes such as compensatory sweating&#44; patient satisfaction with the procedure is high and their quality of life improves&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La hiperhidrosis palmar primaria localizada es un trastorno en la producci&#243;n del sudor que resulta social y laboralmente incapacitante&#46; El prop&#243;sito de este estudio es evaluar los resultados&#44; complicaciones y grado de satisfacci&#243;n de los pacientes con hiperhidrosis palmar primaria tratados con simpatectom&#237;a videotoracosc&#243;pica T2-T3 bilateral en el Servicio de Cirug&#237;a General y Tor&#225;cica del Hospital Universitario Virgen Macarena de Sevilla&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio cl&#237;nico prospectivo hist&#243;rico de 226 simpatectom&#237;as tor&#225;cicas&#46; La muestra la componen 113 pacientes &#40;47 varones y 66 mujeres&#41; de 14 a 50 a&#241;os a&#241;os de edad con hiperhidrosis palmar y axilar primaria&#44; en algunos severa&#46; A todos ellos se les intervino bajo anestesia general practic&#225;ndoseles simpatectom&#237;a videotoracosc&#243;pica T2-T3 bilateral&#46; Se presenta un seguimiento mediante cuestionario en relaci&#243;n con la calidad de vida y grado de satisfacci&#243;n pre y postoperatoria&#46; Se han efectuado an&#225;lisis de frecuencia y descriptivos de los datos obtenidos sobre la t&#233;cnica quir&#250;rgica&#44; calidad de vida y cambios posteriores a la cirug&#237;a y una prueba no param&#233;trica de Wilcoxon para dos variables relacionadas para contrastar diferencias significativas entre la calidad de vida pre y postoperatoria con relaci&#243;n a la hiperhidrosis y sus complicaciones&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El porcentaje de &#233;xito terap&#233;utico ha sido del 100&#37;&#46; La tasa de complicaciones del procedimiento fue del 14&#44;2&#37; e incluy&#243; hemot&#243;rax en dos pacientes&#44; hemoneumot&#243;rax en tres&#44; derrame pleural en dos y m&#237;nima c&#225;mara a&#233;rea apical en 9&#46; De los 106 pacientes a los que se les realiz&#243; seguimiento entre 6 y 12 meses mediante entrevista y cuestionario&#44; un 67&#37; de ellos desarrollaron sudaci&#243;n compensatoria&#46; Un 95&#37; de estos pacientes refiri&#243; mejor&#237;a de su calidad de vida&#44; y un 4&#37; no experiment&#243; ning&#250;n cam bio en ella&#44; sobre todo al considerar la aparici&#243;n de la sudaci&#243;n compensatoria&#46; El 97&#44;2&#37; de los pacientes entrevistados respondieron afirmativamente a la cuesti&#243;n de si se volver&#237;an a operar&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">La simpatectom&#237;a videotoracosc&#243;pica es un m&#233;todo efectivo para el tratamiento de la hiperhidrosis palmar primaria con bajas tasas de morbilidad y nulas de mortalidad&#46; A pesar de la aparici&#243;n de cambios posteriores como la sudaci&#243;n compensatoria&#44; presenta una alta tasa de satisfacci&#243;n y mejora de la calidad de vida de los pacientes&#46;</p>"
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Vol. 40. Issue 2.
Pages 67-71 (February 2004)
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Vol. 40. Issue 2.
Pages 67-71 (February 2004)
Original Articles
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Thoracoscopic Sympathectomy for Palmar Hyperhidrosis: Immediate Results and Postoperative Quality of Life
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J. Loscertales, A. Arroyo Tristán, M. Congregado Loscertales
Corresponding author
jloscert@us.es

Correspondence: Dr. J. Loscertales. Servicio de Cirugía General y Torácica. Hospital Universitario Virgen Macarena. Avda. Dr. Fedriani, 3. 41074 Sevilla. España
, R. Jiménez Merchán, J.C. Girón Arjona, C. Arenas Linares, J. Ayarra Jarné
Servicio de Cirugía General y Torácica, Hospital Universitario Virgen Macarena, Seville, Spain
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Objective

Primary palmar hyperhidrosis is a socially and occupationally debilitating disorder characterized by excessive sweating. The purpose of this study was to evaluate the results, complications, and degree of satisfaction among patients who underwent video-assisted bilateral thoracoscopic sympathectomy of the second and third ganglia (T2-T3) to treat primary palmar hyperhidrosis at the Department of General and Thoracic Surgery of the Hospital Universitario Virgen Macarena in Seville, Spain.

Material and method

A study of 226 thoracoscopic sympathectomies was undertaken based on case histories and a prospective pre- and postoperative questionnaire survey. The sample was composed of 113 patients (47 males and 66 females), ranging in age from 14 to 50 years, with primary palmar and axillary hyperhidrosis, in some cases severe. Bilateral video-assisted thoracoscopic T2-T3 sympathectomy was performed under general anesthesia in all cases. Follow up included a questionnaire on pre- and postoperative quality of life and degree of satisfaction. Descriptive statistics on the surgical procedure, quality of life, and postoperative changes were compiled and frequency analyzed. A nonparametric Wilcoxon test for paired variables was performed to contrast significant differences between pre- and postoperative quality of life related to hyperhidrosis and its complications.

Results

The therapeutic success rate was 100%. Complications were seen in 14.2% of the cases and included hemothorax in two, hemopneumothorax in three, pleural hemorrhage in two, and minimal apical airspace in nine. Of the 106 patients who were monitored over a period of 6 to 12 months through follow-up interviews and questionnaires, 67% developed compensatory sweating, 95% reported improvement in quality of life, and 4% experienced no change in quality of life, mainly because of the emergence of compensatory sweating. Of the patients interviewed, 97.2% said that they would undergo the operation again.

Conclusion

Video-assisted thoracoscopic sympathectomy for the treatment of primary palmar hyperhidrosis is effective, with low rates of morbidity and no mortality. Despite the appearance of postoperative changes such as compensatory sweating, patient satisfaction with the procedure is high and their quality of life improves.

Key words:
Hyperhidrosis
Video-assisted thoracoscopic sympathectomy
VATS
Postoperative quality of life
Objetivo

La hiperhidrosis palmar primaria localizada es un trastorno en la producción del sudor que resulta social y laboralmente incapacitante. El propósito de este estudio es evaluar los resultados, complicaciones y grado de satisfacción de los pacientes con hiperhidrosis palmar primaria tratados con simpatectomía videotoracoscópica T2-T3 bilateral en el Servicio de Cirugía General y Torácica del Hospital Universitario Virgen Macarena de Sevilla.

Material y método

Se ha realizado un estudio clínico prospectivo histórico de 226 simpatectomías torácicas. La muestra la componen 113 pacientes (47 varones y 66 mujeres) de 14 a 50 años años de edad con hiperhidrosis palmar y axilar primaria, en algunos severa. A todos ellos se les intervino bajo anestesia general practicándoseles simpatectomía videotoracoscópica T2-T3 bilateral. Se presenta un seguimiento mediante cuestionario en relación con la calidad de vida y grado de satisfacción pre y postoperatoria. Se han efectuado análisis de frecuencia y descriptivos de los datos obtenidos sobre la técnica quirúrgica, calidad de vida y cambios posteriores a la cirugía y una prueba no paramétrica de Wilcoxon para dos variables relacionadas para contrastar diferencias significativas entre la calidad de vida pre y postoperatoria con relación a la hiperhidrosis y sus complicaciones.

Resultados

El porcentaje de éxito terapéutico ha sido del 100%. La tasa de complicaciones del procedimiento fue del 14,2% e incluyó hemotórax en dos pacientes, hemoneumotórax en tres, derrame pleural en dos y mínima cámara aérea apical en 9. De los 106 pacientes a los que se les realizó seguimiento entre 6 y 12 meses mediante entrevista y cuestionario, un 67% de ellos desarrollaron sudación compensatoria. Un 95% de estos pacientes refirió mejoría de su calidad de vida, y un 4% no experimentó ningún cam bio en ella, sobre todo al considerar la aparición de la sudación compensatoria. El 97,2% de los pacientes entrevistados respondieron afirmativamente a la cuestión de si se volverían a operar.

Conclusión

La simpatectomía videotoracoscópica es un método efectivo para el tratamiento de la hiperhidrosis palmar primaria con bajas tasas de morbilidad y nulas de mortalidad. A pesar de la aparición de cambios posteriores como la sudación compensatoria, presenta una alta tasa de satisfacción y mejora de la calidad de vida de los pacientes.

Palabras clave:
Hiperhidrosis
Simpatectomía torácica videotoracoscópica
Calidad de vida postoperatoria
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Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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